Reflexive Ethnography: A Guide to Researching Selves and Others

Reflexive Ethnography:. Guide to Researching Selves and Others. Charlotte Aull Davies. New York: Routledge, 1999.257 pp.     

Hygiene of Infant-feeding Utensils. Practices and Standards in the Home

Of 758 infants'' feeding-bottles and teats collected aseptically by health visitors in four areas of Great Britain and examined in public health laboratories, less than two-thirds of the bottles and just over half of the teats produced results within an arbitrary “satisfactory” level. The mothers who said they used the hypochlorite method of sterilization and of storage of bottles and teats produced significantly better results. More of the mothers with satisfactory results had attended mothercraft classes. Twenty-two per cent. of babies in the sample were said to have suffered from diarrhoea, or vomiting, or both.The standards of home sterilization of bottles and teats could be improved, and straightforward and effective health education is required, together with professional backing, so that mothers would put into practice what they had been taught.     

Planning the Family in Egypt: New Bodies, New Selves

Planning the Family in Egypt: New Bodies, New Selves. Kamran Asdar Ali. Austin: University of Texas Press, 2002. xii. 233 pp.     

No One Home: Brazilian Selves Remade in Japan

No One Home: Brazilian Selves Remade in Japan. Daniel Touro Linger. Stanford: Stanford University Press, 2001. 342 pp.     

Compliance of Health Care Workers with Hand Hygiene Practices: Independent Advantages of Overt and Covert Observers

Background

Evaluation and feedback of hand hygiene (HH) compliance are important elements of the WHO multimodal strategy for hospital infection control. Overt observation is recommended, but it may be confounded by Hawthorne effect. Covert observation offers the opportunity to decrease observer bias. In this study we conducted a one year hospital-wide HH promotion program that included medical students (MS) as covert observers.

Methods

HH compliance for the five WHO indications was determined by trained and validated observers. The overt observers consisted of eleven infection control nurses (ICNs) and two unit HH ambassadors (UAs) in each of 83 wards. The covert observers consisted of nine MS during their rotating clinical clerkships. Feedback was provided to department heads and staff each quarter.

Results

Of the 23,333 HH observations 76.0% were by MS, 5.3% by ICNs and 18.7% by UAs. The annual compliance rates were MS 44.1%, ICNs 74.4% and UAs 94.1%; P<0.001. The MS found significantly lower annual compliance rates for 4/5 HH indications compared to ICNs and UAs; P<0.05. The ICNs reported significantly improvement from the first to the fourth quarter; P<0.001. This was associated with feedback from the MS of very poor compliance by nurses during the first quarter.

Conclusions

Based on these findings we recommend a two-pronged approach to HH programs. The role of ICNs and UAs is to educate, serve as role models, establish, sustain good HH practices and provide direct feedback. The role of the covert observers is to measure compliance and provide independent feedback.     

Menstrual Hygiene Practices,WASH Access and the Risk of Urogenital Infection in Women from Odisha,India

Menstrual hygiene management (MHM) practices vary worldwide and depend on the individual’s socioeconomic status, personal preferences, local traditions and beliefs, and access to water and sanitation resources. MHM practices can be particularly unhygienic and inconvenient for girls and women in poorer settings. Little is known about whether unhygienic MHM practices increase a woman’s exposure to urogenital infections, such as bacterial vaginosis (BV) and urinary tract infection (UTI). This study aimed to determine the association of MHM practices with urogenital infections, controlling for environmental drivers. A hospital-based case-control study was conducted on 486 women at Odisha, India. Cases and controls were recruited using a syndromic approach. Vaginal swabs were collected from all the participants and tested for BV status using Amsel’s criteria. Urine samples were cultured to assess UTI status. Socioeconomic status, clinical symptoms and reproductive history, and MHM and water and sanitation practices were obtained by standardised questionnaire. A total of 486 women were recruited to the study, 228 symptomatic cases and 258 asymptomatic controls. Women who used reusable absorbent pads were more likely to have symptoms of urogenital infection (AdjOR=2.3, 95%CI1.5-3.4) or to be diagnosed with at least one urogenital infection (BV or UTI) (AdjOR=2.8, 95%CI1.7-4.5), than women using disposable pads. Increased wealth and space for personal hygiene in the household were protective for BV (AdjOR=0.5, 95%CI0.3-0.9 and AdjOR=0.6, 95%CI0.3-0.9 respectively). Lower education of the participants was the only factor associated with UTI after adjusting for all the confounders (AdjOR=3.1, 95%CI1.2-7.9). Interventions that ensure women have access to private facilities with water for MHM and that educate women about safer, low-cost MHM materials could reduce urogenital disease among women. Further studies of the effects of specific practices for managing hygienically reusable pads and studies to explore other pathogenic reproductive tract infections are needed.     

Stories and Selves: Managing the Self through Problem Solving in School

This study examines how a curriculum that aimed to instill in students a way of solving their everyday social problems instead became a site for replaying students' understandings of solutions approved by teachers and thus was limited in shaping their subjectivities. We draw on research in the ethnography of speaking, particularly in school settings, to refine current anthropological interest in the Foucauldian notion of technologies of the self. As a result, we highlight the contextual quality of practices, such as problem solving, used to manage the self.     

Fashioning the Immunological Self: The Biological Individuality of F. Macfarlane Burnet

During the 1940s and 1950s, the Australian microbiologist F. Macfarlane Burnet sought a biologically plausible explanation of antibody production. In this essay, we seek to recover the conceptual pathways that Burnet followed in his immunological theorizing. In so doing, we emphasize the influence of speculations on individuality, especially those of philosopher Alfred North Whitehead; the impact of cybernetics and information theory; and the contributions of clinical research into autoimmune disease that took place in Melbourne. We point to the influence of local experimental and intellectual currents on Burnet’s work. Accordingly, this essay describes an arc distinct from most other tracings of Burnet’s conceptual development, which focus on his early bacteriophage research, his fascination with the work of Julian Huxley and other biologists in the 1920s, and his interest in North Atlantic experimental investigations in the life sciences. No doubt these too were potent influences, but they seem insufficient to explain, for example, Burnet’s sudden enthusiasm in the 1940s for immunological definitions of self and not-self. We want to demonstrate here how Burnet’s deep involvement in philosophical biology – along with attention to local clinical research – provided him with additional theoretic tools and conceptual equipment, with which to explain immune function.     

Objectified Selves: An Analysis of Medicines in Andean Sacrificial Healing

This analysis of medicines used in a Quechua soul-calling ritual in the southern Peruvian Andes demonstrates that the items in sacrificial bundles (despachos) embody the identity of patients. The manipulation of these medicinal objects gives insight into the meaning of the concept of embodiment in the Andean cultural context and expands Western conceptions of embodiment. An examination of the material representation of the body, the sacrificial object, illuminates the components of embodied identity in this particular cultural context. Analysis of the manipulation of medicines further illuminates the potency and efficacy of symbolic healing to transform the phenomenological world of the patient. [ethnomedicine, Andes, embodiment, symbolic healing]